Otc Ex 1 Sum Part 1

Front 1

1.) Parietal Cells secrete ___.
2.) Chief Cells secrete ____.
3.) The Antrum contains gastrin cells (G-cells) which secrete ____.
4.) The parietal cell has receptors for what? (3) *KNOW*
5.) ____ is the target for inhibiting acid secretion.
6.) Which drugs target the parietal cell?
7.) ____ stimulates the parietal cell directly.
8.) What will stimulate gastrin release?

Back 1

1.) HCl (& intrinsic factor for B12 absorption)
2.) Pepsinogen
3.) Gastrin
4.) Histamine, Ach, Gastrin, & PG (all are “bad” for the stomach except PG’s)
5.) Parietal cells
6.) Anticholinergics, H2 antagonists, Omeprazole
7.) Gastrin!
8.) Protein in food, vagal stimulation, Ca, mechanical distention by food, and any factor that increases gastric pH.

Front 2

emollient laxative and drugs name: 1 each
warning

Back 2

not a real laxative
r stool softeners
2 categories:
Ca++ ducosate, 240 mg per caps, Surfak, kaopectate stool softener, once a day up to 3 a day

Na+ ducosate, 50 & 100 mg per cap, ducolax stool softener (Na+, 100mg)

Front 3

1.) Acid secretion is increased by what?
2.) Do NSAIDS cause direct damage or Indirect damage to the gastric mucosa?
3.) What are the 3 main methods for treating acid-peptic disorders?
4.) MOA of Omeprazole (Prilosec)?
5.) Should counsel about what?

Back 3

1.) Milk, Beer, Coffee, and Colas (BOTH caffeinated and decaf!)
2.) BOTH!! (direct, but also delayed b/c they inhibit PG ability to maintain the gastric mucosa)
3.) ~Neutralize existing acid (antacids) ~Reduce secretion of acid (anticholinergics, H2-antagonists, and PPIs) ~Cytoprotection! (Cytotec, bismuth, carafate)
4.) PPI – it is acid activated!
5.) Should be taken WITH/BEFORE meals! (before breakfast or before breakfast and dinner)

Front 4

with water always

Back 4

bulk
emollient
saline

Front 5

1.) List the primary ingredients of antacids in order of their potency:
2.) T or F? Should start w/ the most potent to ensure the acid is neutralized.
3.) What is something we have to worry about w/ Sodium Bicarb?
4.) What do we mean by “Watch for hidden problems” when taking Na-bicarb?
5.) What should be avoided when taking Na-bicarb? *KNOW

Back 5

1.) Na > Ca > Mg > Al Sodium Bicarbonate, Calcium Carbonate, Magnesium hydroxide, Aluminum salts
2.) False! Start w/ least potent to avoid acid rebound!!
3.) Can cause Milk Alkali Syndrome when combined w/ Ca carbonate or more sodium bicarb.
4.) Interactions such as Lithium (Na competes w/ Li in renal tubule and decreases reabsorption of Li)
5.) Other Na-bicarb products: ~Alka-seltzer Blue (ASA & sodium bicarb) ~Alka-seltzer Gold (sodium bicarb) ~Brioschi ~Citrocarbonate ~Baking Soda (pure sodium bicarb) ~Bromo-seltzer

Front 6

warning never @ bedtimes

always @ bedtimes

Back 6

Lubricant

stimulant with senna

Front 7

1.) List the products that contain Calcium Carbonate: *KNOW*
2.) What is the problem associated w/ Ca carbonate?
3.) What is a possible side effect of Ca carbonate?
4.) What is the problem associated w/ Magnesium?
5.) What is the most common side effect of Mg?
6.) What is the Adult MOM dose for use as a laxative?
7.) What is children’s MOM dose for use as laxative?
8.) What is adult MOM dose for use as antacid?
9.) Dose of MOM tablets for adult antacid?

Back 7

1.) Tums, Titralac, Titrilac Plus (w/ simethicone), Maalox Max tablets, Amitone, Chooz Antacid Gum, Di-Gel tablets, Mylanta Supreme, Alka-mints, Maalox Quick Dissolve Tabs, Children’s Pepto Bubble gum flavored chewables.
2.) Acid Rebound (b/c potent & prolonged neutralization of stomach acid.)
3.) Constipation
4.) It is a strong CNS depressant (risk of absorption & toxicity is ONLY significant in renal impairment)
5.) Diarrhea
6.) 2 – 4 tablespoons followed by glass of liquid
7.) Half the adult dose (also w/ water)
8.) 1 – 3 teaspoons w/ a little water up to Four times daily
9.) 2 – 4 tabs w/ a little water up to 4 times daily

Front 8

only suppositories

Back 8

hyperosmotic lax
glycerin + na+ stereate suppositories, 3 g
fleet pedia-Lax suppositories, glicerin liquid

Front 9

1.) T or F? Like Na and Ca, Aluminum has a high neutralizing capacity.
2.) What is a problem associated w/ Aluminum?
3.) Most frequent side effect of Aluminum is what?
4.) List the 2 Aluminum antacid products and how much aluminum each contains: *KNOW*
5.) How can the constipation from Aluminum be countered? *KNOW*
6.) What is the problem associated w/ the Aluminum-Magnesium combos?

Back 9

1.) False! Aluminum has LOW neutralizing capacity
2.) Binds phosphate in the gut, forming insoluble phosphate salts that are excreted in the feces. Results in hypophosphatemia.
3.) Constipation (just like Calcium Carbonate)
4.) ~AlternaGEL = 600mg/5cc ~Amphogel (only generic) = 320mg/5cc
5.) Combine it w/ Magnesium (b/c Mg causes diarrhea which can cancel out the constipation!!)
6.) You increase your risk of absorption and toxicity of the 2 substances. (mainly problem w/ reduced renal function

Front 10

fastest laxative

Back 10

hyperosmotic lax

Front 11

1.) List the “Aluminum-Mg-Simethicone” products: (5) *KNOW*
2.) Which of those is approved for “breakthrough heartburn” even when on Rx heartburn med?
3.) What is Magaldrate (Riopan Plus)?
4.) Describe Simethicone:
5.) List some products that contain ONLY simethicone: (5)

Back 11

1.) ~Maalox Antacid & Antigas Liquid Regular Strength (200-200-20) ~Maalox Max Antacid & Antigas Liquid (400-400-40) ~Mylanta Liquid (200-200-20) ~Mylanta Extra Strength Liquid (400-400-40) ~Mylanta Ultimate Strength Antacid (500-500)
2.) Mylanta Ultimate Strength Antacid (rapid acting)
3.) Chemical mix of Al & Mg hydroxides that is converted to Al & Mg ions in the stomach acid. Contains simethicone.
4.) A defoaming agent. Works by reducing suface tension of gas bubbles so can be eliminated more easily by burping or passing gas.
5.) ~Gas-X, Mylanta Gas, Phazyme, Maalox Anti-Gas Tabs, Simethicone

Front 12

may give lipd pneumonia

Back 12

emollient lax & lubricant lax

Front 13

1.) What is in Gaviscon?
2.) Describe the “Rafting effect” associated w/ Gaviscon:
3.) What is it beneficial for?
4.) Gaviscon must be taken w/ _____.
5.) What is in Maalox Antacid Barrier?
6.) T or F? Gaviscon can be used for GERD and as a regular antacid.
7.) What is in Rolaids?
8.) What is in Eno powder?
9.) What is in Gripe Water?

Back 13

1.) Alginic Acid + Sodium Alginate
2.) It has foaming, floating, and viscous properties.
3.) Treating GERD
4.) Full glass of water
5.) Alginic acid (just like Gaviscon)
6.) False! CANNOT be used as antacid b/c does not contain enough antacid ingredients to be useful as an acid neutralizer.
7.) Ca carbonate & Mg hydroxide
8.) 2680mg of Sodium Citrate per pak (855 mg Na)
9.) Na bicarbonate w/ oils

Front 14

4 lubricant lax r

Back 14

mineral oil heavy
Fleet mineral oil: left side
Phillip M-O: 1.25 ml min oil & 300 mg Mg(OH)/ 5 ml adult 2-4 tbsp
Kondremul: 55 % min oil+ acacia

Front 15

1.) List the major Drug Interactions associated w/ Antacids:
2.) What is in Sucralfate?

Back 15

Chelation and Binding w/ polyvalent cations ~Increasing gastric pH ~Increasing Urinary pH (weakly acidic drugs like Aspirin)
2.) Complex salt of sucrose sulfate & Al hydroxide (dissolves in the stomach acid & releases Al)

Front 16

never give lubricant to


what r dosage regimens?

Back 16

bedridden or @ bed time,
Adek deficient
pregnant wo
not to pt on anticoagulant

mineral oil; adult: 1-3 tbsp daily
children 6-15 ml daily

Front 17

Bismuth Salicylate:

1.) T or F? It is an aspirin.
2.) List the 3 agents which contain Bismuth:
3.) T or F? It has acid neutralizing properties.
4.) Pts taking ____ should be warned not to take Pepto-bismol.
5.) Common side effect:
6.) What is one thing we cannot forget about Pepto-bismol (and bismuth salicylate in general)

Back 17

1.) FALSE! It IS a salicylate, but NOT an aspirin
2.) ~Pepto-Bismol ~Kaopectate ~Liquid Maalox Total Stomach Relief Maximum Stength
3.) False!
4.) Anti-coagulants
5.) Blackening of tongue and stools
6.) Watch out for Reye’s syndrome!! (do not give to kids, esp. when they are sick w/ the flu!!)

Front 18

wich one for endoscopy, colonoscopy or drug poisoning clearance

Back 18

saline
colonoscopy with Na+PO4

Front 19

H2 receptor Antagonists

1.) Name the drugs in this category:
2.) Which is most widely used?
3.) Which has interactions w/ CYP450’s?

Back 19

1.) Pepcid AC (famotidine), Tagamet HB 200mg, Zantac (Ranitidine), Axid AR (Nazatidine)
2.) Pepcid AC
3.) Tagamet HB

Front 20

wich 2 ways for saline

Back 20

supp & oral
Mg may absorb up to 20%
PO4 may absorb up to 10% by enema

Front 21

PPI’s

1.) Name the 1 drug in this class:
2.) Cautions?
3.) What is the most effective dosage regimen?
4.) What MUST we remember if a pt is taking a PPI and an H2 antagonist?

Back 21

1.) Prilosec OTC,
2.) Can allow bacterial growth, inhibits absorption of B12
3.) 30 min. before breakfast! (but can be prn)
4.) The PPI should be taken FIRST and the H2 blocker can be taken later. (the PPI needs the active pumps in order to work)

Front 22

Senna Class:

1.) List the Senna products: (8)

Back 22

Senna Class:

1.) List the Senna products: (8)

1.) Senokot tabs, Perdiem Overnight Relief Tablets, Ex-lax tablets & Chocolate, X-Prep Liquid, Fletcher’s Castoria, 4kids (root beer flavored), Nature’s Remedy, Senokot & Pericolace {not a colace}(Senna w/ docusate sodium), Swiss Kriss Herbal Laxative tabs (flake form).

Front 23

Misc. Products:

1.) Describe Beano
2.) Indicated for?
3.) Drug Interactions?
4.) Cautions?
5.) Describe Lactaid:
6.) Original Lactaid strength?
7.) Lactaid Ultra strength?
8.) Describe Prelief:
9.) Add ____ packets of Prelief to a serving of acidic food or beverage.

Back 23

1.) Alpha-glucosidase enzyme. Hydrolyzes complex sugars into simple sugars.
2.) Flatulence and/or bloating
3.) MAOI’s
4.) Diabetics!! (glucose spike)
5.) Lactase Enzyme (makes milk more digestible)
6.) 3000 units
7.) 9000 units (caplets or chewable tablets)
8.) Calcium glycerophosphate, a food-grade mineral classified as dietary supplement. Used w/ acidic foods or beverages for more comfortable eating.
9.) 2

Front 24

Bisacodyl:

1.) List the Brand name item in this category:
2.) How does it come?
3.) What is the form targeted towards women?
4.) List the other products that contain bisacodyl:
5.) EC versions should NOT be ____ or administered with __________.
*read the details in the packet

Back 24

2.) Dulcolax *very widely used!
3.) 5mg tablet OR 10mg suppository
4.) Correctol: The women’s laxative (Pink Box)
5.) Carter’s little pills, Alophen tablets, Doxidan
6.) Broken, crushed, or chewed ; Alkaline materials such as antacid products or H2-blockers!!